This proposal will demonstrate the capabilities of Oregon Health &Science University (OHSU) to continue being part of the Eunice Kennedy Shriver Maternal Fetal Medicine Units Network of the NICHD. OHSU has been an active participant in the MFMUN for the last 5 years. We have demonstrated capabilities to propose novel research protocols and to cooperate in all activities related to all ongoing clinical trials in the MFMUN. We have recruited participants in all the protocols. We have served on subcommittees for new protocols and have provided intellectual input into their development. We have published original manuscripts and presented posters at national meetings and attended all the meetings of the Steering Committee. We have managed a complex collaboration with other sites that are part of our center and have effectively coordinated collection and transfer of data from our center to the NICHD. We are proposing a novel concept project entitled "RCT of Contingency Management for Smoking Cessation in Pregnancy". This proposal addresses with innovation the most important complication of pregnancy in the U.S., preterm birth. OHSU has demonstrated capabilities and scientific leadership in research in this topic. Our Division of Maternal Fetal Medicine is composed of 8 specialists in MFM, 1 MFM-geneticist, 3 fellows, 2 OB/GYN investigators one focused on clinical effectiveness, one on advanced fetal echocardiography and 5 scientists. In addition to the faculty, our research support group includes 4 research nurses, a general Ob/GYN and 3 research associates. OHSU is the only teaching center in the State of Oregon. It provides state of the art obstetric services with 2557 deliveries in 2009;36% were considered high risk. This application includes participation of the Providence-Sacred Heart Medical Center (PSHMC) in Spokane, Washington, site which was added to our Center in July 2008. PSHMC has been successful in all activities related to recruitment of participants into the protocols authorized by NICHD. It is the largest provider of obstetric services in the Inland Northwest region of the U.S. with 2704 in 2009 deliveries of which 32% were high risk, for a total number of 5261 deliveries a year at our center. PUBLIC HEALTH RELEVANCE: Participation of OHSU in the MFMUN will bring discoveries made by this research initiative into clinical practice in Oregon and Washington, with tangible improvement in public health. These centers provide training to hundreds of students and direct medical care to thousands of women, their babies and families. We will further improve, prevent and reduce adverse outcomes of pregnancy, preterm birth, low birth weight, maternal morbidity and mortality in large urban and rural areas of the Pacific Northwest of the U.S.